Radiotherapy is a specialised treatment that needs particular machinery and specially qualified staff. Because of this, radiotherapy departments are in larger regional and teaching hospitals. So you might have your initial cancer treatment (such as surgery) at your local hospital and then you’ll be referred to the nearest radiotherapy department which may be at a different hospital.
types of radiotherapy
There are two main types of radiotherapy:
- external beam
- internal
The information here is about external beam radiotherapy as this is the kind most commonly used for the cancers that teenagers experience.
what happens?
Radiotherapy is normally given as a series of short daily treatments. It will be given every day from Monday to Friday with a rest at weekends. Each treatment is called a fraction. Giving the treatment in separate daily fractions means that less damage is done to normal cells and so hopefully there will be fewer side effects.
How much treatment you have depends on certain things:
- the type of cancer and where in your body it is
- what other types of treatment you’re having (like chemo, surgery)
- your general health.
For these reasons, treatment is planned to suit your individual situation.
planning
To make sure your radiotherapy is as effective as possible, treatment has to be carefully planned. This means one or more visits to the department (before treatments starts) where you’ll lie on a machine called a ‘simulator’. This helps the staff to work out the best position for you to be in during treatment. It means that treatment will be really accurate and will be targeted at the cancer while doing as little harm as possible to surrounding tissues.
During treatment planning, you need to lie very still on a hard couch (this might be a bit uncomfortable) for a few minutes so that accurate measurements can be taken and your exact position recorded. This means the radiographer can make sure you are lying in the right position everytime you need treatment.
skin markings
Once the treatment area has been finalised, ink markings are made on your skin to pinpoint the exact place where the radiation needs to go. Staff will explain how to look after these markings. If they start to rub off, let your radiographer know. Sometimes, two or three permanent pinpoint tattoo marks are also made on the skin. This will only be done with your permission.
what about stereotactic radiotherapy/gamma knife?
Stereotactic radiotherapy means doctors can direct radiation more accurately at brain tumours. It’s given from a standard radiotherapy machine which has been adapted. Radiotherapy is directed from many different angles which overlap at the brain tumour. This means the dose going to the tumour is very high, but the dose affecting surrounding healthy tissue is very low. It’s done either by moving the machine during treatment or by aiming individual beams from a number of different directions. You may need to wear a frame fitted to your head (during treatment) to prevent movement.
Sterotactic radiosurgery (gamma knife) uses a similar technique again for brain tumours. It’s not a knife, but very precisely targeted beams of gamma radiotherapy from hundreds of different angles, which cross at the point of the tumour. Usually only one session of radiotherapy is needed which takes about 4-5 hours. In order to have the treatment, you will have a specially made metal frame attached to your head. You’ll then have several scans and x-rays to find the precise area for the treatment to be given. To have the treatment, you lie with your head in a large helmet, which has hundreds of holes in it to allow the radiotherapy through.
